title: Comparison of 64-slice multidetector computed tomography with spectral analysis of intravascular ultrasound backscatter signals for characterizations of noncalcified coronary arterial plaques.
abstract: In vivo identification of plaque composition may allow the detection of vulnerable plaques before rupture. However, the clinical relevance of multidetector computed tomography (MDCT) in characterizing coronary plaques is currently a subject of debate. We compared 64-slice MDCT with virtual histology to investigate the potential role of 64-slice MDCT in the differentiation of composition of noncalcified coronary plaques. Fifty-nine consecutive patients (stable/unstable angina 34/21) were enrolled. Mean computed tomographic (CT) density (Hounsfield units) of noncalcified coronary plaques (n = 80) was compared with a relative volume of each plaque component (fibrous, fibrofatty, calcium, and necrotic core) analyzed by virtual histology. Mean heart rate during MDCT was 58 +/- 9 beats/min. There was a negative correlation between mean CT density and the necrotic core (r = -0.539, p <0.001) and a positive correlation between mean CT density and the fibrotic tissue component (r = 0.571, p <0.001). Mean CT density of the plaques with a <10% necrotic core was significantly higher than that of a >or=10% necrotic core (93.1 +/- 37.5 vs 41.3 +/- 26.4 HU, p <0.001). However, overlapping of mean CT densities between plaques with a <10% necrotic core and those with a >or=10% necrotic core was found. In conclusion, mean CT density of noncalcified coronary plaques measured by 64-slice MDCT may depend on the relative volumes of the necrotic core and fibrotic component. Sixty-four-slice MDCT may have the potential for determining composition of noncalcified coronary plaques, which needs further studies for clinical application.
authors.affiliation: Department of Cardiology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Byoung-Joo
authors.initials: BJ
authors.lastname: Choi
authors.forename: Doo-Kyoung
authors.initials: DK
authors.lastname: Kang
authors.forename: Seung-Jea
authors.initials: SJ
authors.lastname: Tahk
authors.forename: So-Yeon
authors.initials: SY
authors.lastname: Choi
authors.forename: Myeong-Ho
authors.initials: MH
authors.lastname: Yoon
authors.forename: Hong-Seok
authors.initials: HS
authors.lastname: Lim
authors.forename: Soo-Jin
authors.initials: SJ
authors.lastname: Kang
authors.forename: Hyoung-Mo
authors.initials: HM
authors.lastname: Yang
authors.forename: Jin-Sun
authors.initials: JS
authors.lastname: Park
authors.forename: Mingri
authors.initials: M
authors.lastname: Zheng
authors.forename: Gyo-Seung
authors.initials: GS
authors.lastname: Hwang
authors.forename: Joon-Han
authors.initials: JH
authors.lastname: Shin
mesh_terms: D023921:Coronary Stenosis / Q000175:diagnosis* / Q000503:physiopathology; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods*; D018084:Ultrasonography, Interventional / Q000379:methods*